An unhealthy distraction

HEALTH POLICY was a cornerstone of Fine Gael’s huge electoral success last year. Voters were promised a Dutch-style healthcare service within years, to be delivered by a minister with zeal and vision – a medical doctor and former trade union negotiator. Dr James Reilly as minister for health, a poacher turned gamekeeper, was to become the agent of change.

Great expectations – yet great disappointment has followed his performance so far.

For a senior Minister to face a vote of confidence less than 18 months in office is unusual, if not unique. And for a senior Minister to find himself listed in Stubbs Gazette for failing to honour a debt is quite without precedent.

No sooner had Dr Reilly survived last week’s vote in the Dáil, than he has found himself again embroiled in controversy on where to locate national primary care centres. The Minister favoured locating two of the centres in his Dublin North constituency. This the HSE has rejected because they failed to meet criteria for selection. Undaunted, Dr Reilly quickly added Swords and Balbriggan to an expanded list.

It smacks of a return to stroke politics of earlier times – the 1960s and early 1970s. Then ministers of all parties used and abused discretionary powers to rig constituency boundaries for party advantage, and to reverse on appeal some decisions made by the planning authorities. Fine Gael and Labour came into government determined to uphold the highest standards in public life. In this instance, Dr Reilly has failed to do so. He has acted in a less than transparent and objective manner, by ignoring the criteria already set for site selection and by favouring two locations in his own constituency. Last week, before this controversy arose, the Minister had won easily a vote of confidence. His victory of Pyrrhic proportions flatters to deceive. It greatly underestimates the Minister’s political vulnerability, and the public’s declining confidence in him, and his ability to reform our health services and control its budget.

Dr Reilly is presiding over a dysfunctional department, where he exercises power in an autocratic manner, without much apparent concern for transparency or public accountability. Relations with his junior minister, Róisín Shortall – increasingly strained on policy matters in relation to primary health care and marked by personality clashes – have degenerated into a succession of public disagreements. Ms Shortall in her criticisms of her political boss has been willing to wound but afraid to strike – as she showed again last week. She was willing to vote confidence in a Minister in whom she is unwilling to express any confidence. This has allowed Dr Reilly to claim, and rightly, her actions speak louder than her words.

For Government, this embarrassing sideshow is an unwelcome distraction at a critical time. It raises tensions between the Coalition parties, and strains Coalition solidarity ahead of some tough challenges. In November, the Government has a referendum to fight and win. In December it has a budget to discuss, and agree. In the meantime it must prepare for Ireland’s presidency of the European council in January. It is time for the Taoiseach and Tánaiste to assert and impose their authority, or else risk losing it.

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